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Pain control options?

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Old 10-03-2013, 02:44 PM   #1
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Default Pain control options?

This is kind of hard to write as it is personal but i'd like some weigh in's on the subject.

Dh and i are "seniors", me being 51 and he is 65 and we have our share of aches, pains, ailments, even serious disease states. DH is on oxycodone for severe chronic pain (due to a disease state which i won't go into) and he also suffers from arthritis, etc. and i have fibromyalgia, CFS, and a lot of arthritic pain in my body.

We both eat well, i exercise, and we take lots of supplements including joint supplements which haven't done much. DH seems to be somewhat resistant to oxycodone (don't know the correct terminology) and it BARELY takes the edge off of his chronic pain (which really sucks) but that's what we're stuck with. Recently he accidentally skewered his leg with a fire pit utensil and i put him on aleve. i hate NSAIDS, i know the risks and side effects of those drugs but unfortunately because of age and circumstance, have crossed the line from preaching against it to understanding why people take these drugs when they need relief and it can't be found in alternatives. i'm trying to get by without taking it or doing it sporadically but my husband oddly enough did find some small relief in taking it as he has to work to provide income but of COURSE we're very conflicted taking these drugs.

Any comments by those who are trying to manage chronic pain and are taking NSAIDS are welcome
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Old 10-03-2013, 04:18 PM   #2
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HI,
I am so sorry that you both have such pain.
I am in the same boat and I take celebrex. I realize gthat it can have heart related side effects according to some but when I had to have some surgery and came off of it in preperation for the surgery,I COULD NOT WALK.

Therefore for me, it is a not a choice and I take 2 a day in the morning and evening. It does not take away all the pain but it helps me to manage.

I try to stay away from any narcotics as these are worse than NSAIDs in my opinion.

Best of luck .
Sheridan
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Old 10-03-2013, 05:13 PM   #3
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Hubby and I are in our 40's but on disability for pain, mobility, and other health issues.
He's on daily vicoden and I'm on a combination of non-narcotic pain meds, antidepressants and supplements for pain (fish oil, vitamin D, tramadol, cyclobenzaprine, amitriptyline, citalopram).

Pain is no fun, but I am not clinically depressed. However depression and pain both respond to the same neurotransmitters so low doses of antidepressants often are used to improve sleep and alleviate pain.

I'm also on miripex for restless leg and periodic limb movement disorder (basically if I don't take the miripex, I thrash around so violently in my sleep that hubby ends up with bruises.

I can't take NSAIDS as they trigger severe asthma and copd. I accidentally discovered my NSAID intolerance my first year on medicare. We ended up in the medicare "gap" and no money to buy even otc NSAIDS. I was in intense pain, but my copd disappeared. I was able to discontinue all asthma and decongestant medications (three pills and two inhalers) since giving them and I no longer have chronic bronchitis nor do I get pneumonia every winter loke I did before.

My neurologist and the pain specialists have told both hubby and I that we would be abke to use far less pain meds if we used the meds to prevent pain rather than trying to get rid of it when it occurs.

This is counter-intuitive as most of us would rather not take more pain meds than we absolute need. It seems to make sense to postpone pain relief as long as possible, but that only makes the pain stronger and less responsive to pain relief.

Hubby and I have learned though that we can use a lot less pain meds if we medicate to prevent pain rather than to treat it. Just as an example, on a bad flare of the fibro, I will max out my tramadol and tylenol if I wait until the pain is bad. I can take much less, up to half just by medicating in smaller, but more frequent doses.

2 pills every 6 hours is my max dosage, and if I wait any longer than 6 hours the maximum dose won't be enough to control the pain. However if I take 1 pill every 4-5 hours I get much better pain relief.

I only take the cyclobenzaprine (a muscle relaxant) when the other meds don't help enough. I could take it up to 3 times a day, every day, but normally I only take it at night during severe pain flares. It makes me too sleepy to take during the day.

For inflammation, even though it's an otc, the fish oil has helped more than prescription NSAIDS, but it took a month or so to notice the improvement.
I do take 4g per day though (4000 mg).

Pain control also needs to constantly be evaluated and reevaluated. I've been able to scale back some of my meds during the summer months (I also have fibromyalgia and my pain is variable through the year). Hubby's pain is more constant and a result of a degenerative condition so every few years he requires a dosage increase. He was doing well on Darvocet, but had to switch to Vicoden when Darvocet was discontinued.

For me, tramodol actually works better on my pain than a true narcotic, but for hubby Tramadol does almost nothing. He does take an NSAID to boost pain relief and finally has taken my suggestion to add the fish oil with the doctor's ok.
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Old 10-03-2013, 06:49 PM   #4
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Thank you both and gosh i'm sorry you all are going through what you are, makes us feel not so alone. Wish i could divulge more on what my husband is suffering from but i don't want to break his confidence.

Kaplods, thanks for bringing up the idea of management instead of chasing down pain once it's out of control, i did know that and it's important to be reminded of it, interestingly i was just admonishing a list mate on another forum i'm on (holistic pet forum) about keeping on top of her cats cancer pain and not worrying about the long term side effects just yet (we tend to minimize our pets chronic pain or don't even think about pain management with them) so maybe i will just bite the bullet and continue giving Aleve to my husband, i don't know if it will allow him to lower the dosage of oxycodone but it would be nice! Problem with that drug is it's variability throughout the day, not a steady dose of pain control and i was surprised that he felt Aleve did "something" as Advil doesn't cut it for us (and my chiro said it basically has a life of 1 1/2 hours in the body, far far less than Aleve) i just hate hate hate the thought of side effects (well don't we all??!!) but i know he has to be able to work and he's skirting the edge of disability if it goes any further it still makes me really nervous and afraid. He doesn't have asthma or COPD and i'm glad that you discovered that side effect in yourself! That also scares me, trying to figure out S/E's and what particular drug they're coming from, etc., etc., ad nauseum.

As for me, interestingly the best thing i've found (and i take a lot of supplements and alternative medicine) for my chronic viral flares of CFS is 1/2 tablet of Vicoden. Who would have thought it would help with that and make me feel almost normal? Don't understand that one. NSAIDS in that respect do nothing for me. So i am very thankful for Vicoden (i take it sporadically).
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Old 10-03-2013, 08:12 PM   #5
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You and your husband might want to consider a medication reevaluation from whoever prescribed the oxycodone. A dose adjustment or a different extended release pain medication may be more appropriate.

Also, in some cases, especially in the long run, otc pain meds can have more dire consequences than narcotics, especially for people who are unlikely to overmedicate or misuse medication.

One of the reasons my hubby had his last vicoden increase was because his NSAID was tearing up his stomach. The doctor tried him om another NSAID (supposedly one less likely to cause stomach irritation) and it was even worse.

If you can get a referral to a pain specialist or pain clinic, I'd recommend it highly. It might actually be safer to take a higher dose of oxycodone than to take a lower dose with the Aleve.

In my fibromyalgia support groups I have met some people who take methadone for pain that hasn't responded well to other narcotics or because other narcotics were too sedating.

I'm just wondering if an increasing your husband's oxycodone dose or taking a smaller dose more frequently or switching to another extended release narcotic altogether or adding a low-dose antidepressant might not be more effective and possibly even safer than adding the Aleve.

I know in hubby and my case our doctor has been VERY adamant that we not take any otc medications without clearing it with him first, because tof the possibility of interactions and side effects.

For example when my husband first started taking an nsaid, even though it was only otc strength, the doctor changed his bloodscreening schedule from every 4 months to every 3.

I know our doctor has steered us away from several otc medications because of possible interactions.
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Old 10-03-2013, 08:23 PM   #6
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Kaplods,

All you've said is what i've suspected and been afraid of, that otc NSAIDS may in the long run pose greater risk.

We are very fortunate to have a doctor that is a personal friend. We're very unfortunate not to have any health insurance and very little money (they won't qualify us for disability) so labs are out and it pretty much sucks. i just shot off an email to our doctor about Aleve, we are just pretty surprised that he got some kind of noticeable pain relief on it, since Oxy does barely anything--i think he's on 15 mg 4X a day?? Which is kind of in the higher range, i understand

His doctor is trying to transition him to methadone to see if that helps because it's a longer acting med and when my husband takes one he notices no difference however his pharmacist said that it can take a few days as the drug has a cumulative effect and his RX was to take 1 daily for a week, then slowly titrate up and slowly readjust the oxy. We haven't really pursued that because of not seeing a noticeable effect w/the meth but maybe we should give it a real try. Just so scared of the otc NSAIDS! Oh, he is on a low dose of trazadone i think, an old school anti-depressant.
Ugh idk what to do. All of it has it's potential risks and S/E's and none of us can foresee the future
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Old 10-03-2013, 09:06 PM   #7
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Medical expenses drove my husband and I into bankruptcy nine years ago, and we had great insurance. 90% of nearly EVERYTHING was covered, so essentially we had to file bankruptcy because we couldn't afford the 10% we were responsible for.

We were very lucky that we didn't become unable to work at the same time. Hubby was told at 17 that his degenerative joint condition would put him in a wheelchair by 30. He's 43 and so far no wheelchair. We were caught by surprise with my mystery health issues(which turned out to be fibromyalgia, possibly chronic fatigue, autoimmune disease, copd, and sleep apnea, along with metabolic syndrome, ibs and an assortment of issues that tend to come with fibro). Getting a diagnosis cost my husband his job and drove us into bankruptcy.

Had just gotten my disability approved when my husband fell on the ice, severely tearing his rotator cuff. The injury did not disable him, so much as the recovery did. He only recovered partial use of the arm, but being off work (from a VERY strenuous, active job and in too much pain to exercise) weakened the muscles that had been compensating for his joint weakness.

I know I'm way off topic and starting to rant. I'm just so sorry that you can't get appropriate medical treatment just because healthcare is considered an unnecessary luxury
When I first became unable to work, we applied for assistance (food stamps and help with our outstanding hospital bills). Our rent was taken into consideration, but not our medications. We lived in a dump, so our rent was about $300 cheaper than average. If our rent had been $50 higher, we would have qualified. Essentially assistance programs consider rent a necessity but medication an unnecessary luxury.

At the time, we could have survived living in our van. We would not have survived without our meds (which cost us nearly three times our rent and utilities).

I just don't understand how anyone can oppose national health care. I'm conservative on many issues, but I just don't believe health care should be treated as a luxury rather than as a basic human right.

I'm ranting, but not for ourselves. We were lucky. My BIL's mother had to fight for three years to get approved for disability for a brain tumor, basically because she is uneducated and didn't know how to fill out the paperwork.

It's all just so frustrating.
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Old 10-04-2013, 01:29 PM   #8
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Completely agree with this rant, rant away.

i just hate dealing with all the what if's with meds for chronic pain, don't really know what to do. i do know that he was asking for the Aleve and i'll give it to him until we can figure out what to do
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Old 10-04-2013, 02:53 PM   #9
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I am on a journey to self discovery and I understand I am in no way in as much pain as you are. However, instead of medication I try to control pain with foods by using foods high in anti-inflamatory properties. One of the best is 100% tart cherry juice and turmeric, garlic, onions are every day staples for me. They have seemed to ward off a lot of muscle spasms and joint pain I had been having.
My journey is doctor guided and he believes in order to curtail pain we have to remove anything that causes inflamation from our bodies. I am currently on an elimenation diet to figure out how my body reacts to different foods. Maybe something like that may not completly rid you of pain but help you manage it better. Just a thought.
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Old 10-04-2013, 03:36 PM   #10
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I agree with Keywis25 that food can have a huge impact on pain. I have fibromyalgia and I find avoiding gluten and dairy helps tremendously. If you haven't already, would you consider trying an elimination diet? I'm not saying it definitely would help, but you never know, it might.
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Old 10-04-2013, 04:05 PM   #11
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Quote:
Originally Posted by Seashell84 View Post
I agree with Keywis25 that food can have a huge impact on pain. I have fibromyalgia and I find avoiding gluten and dairy helps tremendously. If you haven't already, would you consider trying an elimination diet? I'm not saying it definitely would help, but you never know, it might.
Yes that is something i have not done yet. Have totally switched up my diet since losing all the weight, eat very healthy now but still do dairy and probably some gluten.

i need to get DH off aspartame, he started drinking it for his stomach, the fizzy water with sweetener that tastes like strawberry or cherry, etc. he wont drink fizzy non sweetened water like i do, he used to do lemon and stevia water which i will try my best to get him back on, don't know if it will make a difference in his symptoms, probably barely and controversy abounds about artificial sweeteners, i am not a fan of them

i do take turmeric, boswellia, chinese herbs, a plethora of supplements and am a true lover of wholistic medicine but unfortunately there are not many options to completely control severe chronic pain. And.. i'm fearful of especially turmeric for my husband as it can conflict with allopathic medicines especially uptake in the liver--so many variables to consider! i am trying to get him on a better diet and i give him a supergreen food drink and smoothies with spinach/kale, blueberries, etc. the unfortunate thing is that even the healthiest diet might not be the one for *you* and that takes detective work. When you are broke and ill, detective work is so hard. i have to do it for myself, my husband and even my cat that has a few chronic disease state.

Yes i am whining and ranting!!
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Old 10-04-2013, 05:44 PM   #12
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Quote:
Originally Posted by ReillyJ View Post
Yes that is something i have not done yet. Have totally switched up my diet since losing all the weight, eat very healthy now but still do dairy and probably some gluten.

i need to get DH off aspartame, he started drinking it for his stomach, the fizzy water with sweetener that tastes like strawberry or cherry, etc. he wont drink fizzy non sweetened water like i do, he used to do lemon and stevia water which i will try my best to get him back on, don't know if it will make a difference in his symptoms, probably barely and controversy abounds about artificial sweeteners, i am not a fan of them

i do take turmeric, boswellia, chinese herbs, a plethora of supplements and am a true lover of wholistic medicine but unfortunately there are not many options to completely control severe chronic pain. And.. i'm fearful of especially turmeric for my husband as it can conflict with allopathic medicines especially uptake in the liver--so many variables to consider! i am trying to get him on a better diet and i give him a supergreen food drink and smoothies with spinach/kale, blueberries, etc. the unfortunate thing is that even the healthiest diet might not be the one for *you* and that takes detective work. When you are broke and ill, detective work is so hard. i have to do it for myself, my husband and even my cat that has a few chronic disease state.

Yes i am whining and ranting!!

The detective work is hard, especially when you are trying to manage healthcare for others as well as yourself.

It also isn't easy or fair that the comforting foods we crave (because they help relieve pain the short term) are the most damaging in the long run, namely high glycemic carbs.

I have never done a strict elimination diet, but I have tried (separately) eliminating wheat, gluten, sugar, most carbs, caffeine, and artificial sweeteners.

For me, I've found that wheat and sugars (even healthy ones) increase my pain and other symptoms most dramatically. Other gluten grains aren't as aggravating, but I avoid them too, mostly. Traces of gluten from wheat and other grains don't trigger a noticeable reaction, so I don't have to be as careful as someone with celiac disease (which thankfully was ruled out).

Caffeine helps me with pain relief, but to prevent it from interfering with sleep I stop by 5pm and usually by 3.

Aspartame doesn't affect me noticeably one way or the other. I prefer Splenda, but also use stevia, xylitol (birch sugar), and monk fruit-based sweeteners. If you combine sweeteners, they're often sweeter than equivalent amounts of one. For example one teaspoon of Splenda mixed with one teaspoon of aspartame or xylitol is sweeter than two teaspoons of either. Mixing sweeteners allows me to use less. It also lowers the "dose" and exposure to cumulative effects. Since every sweetener has different associated risk.

Reduced carb diets, such as The Zone, South Beach, The Meditteranian Diet, Paleo, and even Atkins (along as it's Atkins with lots of veggies and berries in a rainbow of colors) have been found helpful in reducing chronic pain (especially for fibromyalgia, arthritis, MS, connective tissue disorders, and even for many cancers).

It doesn't help either, that the most damaging foods are also the most affordable.

None of this is easy or inexpensive unfortunately.

Btw, we also have a cat with health and pain issues. The weather is wet, cool, and stormy, and hubby, cat, and I are all miserable.

Even the cat has been whining and ranting in her own way, today. She's been very vocal in her constant, complaining meow. She begs to be petted, but won't sit still for petting and complains when you touch her that you're "doing it wrong" when you try.

I know how she feels.
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Old 10-04-2013, 06:36 PM   #13
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Awwww poor kitty, LOL. i pour my heart and soul into my animals and i ALWAYS get the hard cases which tear me apart! It's not so much the troubles that come, it's the lack of answers. Give me troubles, fine but give me wisdom and answers to work through and solve them and that seems to elude me on a number of fronts! That's the part that i hate the most. That and having to use allopathic drugs BUT i have to say i'm forever grateful for them because they have provided a modicum (sp?) of relief when nothing else has.... especially for my poor cat (on Atopica for skin disease).


i *think* my diet is relatively low carb and certainly low sugar.

My daily diet is:

1 slice dave's seed bread topped with a whole egg, cheddar cheese, SF jam, and some coconut oil on the bread

a huge bowl of non fat unflavored unsweetened Greek Yogurt sweetened with stevia and at least a cup of berries (strawberries or raspberries or blueberries, usually strawberries) and about a heaping T. of slivered raw almonds

Whey protein drink no sugar, sweetened with stevia and i add water, blueberries, kale, spinach and a supergreen food and sometimes a T. of plain PB or almond butter

dinners always a HUUUGE salad made mostly of mixed greens (romaine, baby spring mix salad) and julienned rainbow mix (broccoli, cauliflower, cabbage, a bit of carrots), raw mushrooms, grilled chicken breast and 1/2 large avocado or 2 pieces Tilapia (sp?) and a huge bowl of mixed frozen stir fry veggies and i add some tomato sauce.

snack is 1 cup unsweetened almond milk, 2 heaping T unsweetened cocoa powder, stevia and guilty pleasure a bit of flavored liquid vanilla coffee creamer (sugar free)

So it seems to me that's relatively low carb and low sugar and healthy but wheat is included in the bread. i have no idea what i react to. And the problem is (and not likely i will change this) is i'm very strict all days except for Friday. it's my cheat day and it keeps me on track the rest of the week. But my pain level isn't nearly approaching what my husband is dealing with and i only have the energy at the moment to ADD to his regime (healthy smoothies, vitamins, etc.) and not try to modify. sighhhhh.
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Old 10-04-2013, 07:04 PM   #14
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It's obvious that you're very well informed and doing virtually everything that you can. It's just so heartbreaking and frustrating to know that there may be (or sometimes certainly are) treatments that are out of reach because of lack of insurance/funds.

I've recently begun hearing of patients being turned away for lack of insurance, even if the patient offered to pay in cash, up front. Hopefully this is a misinterpretation of what actually occurred, or at least reflects isolated incidents and doesn't become common practice.

We did find a dentist, thankfully who is willing to give a substantial discount if paid in cash up front. I have a lot of dental work that needs doing and it'll probably take years to get done at a pace we can afford.

I'm grateful for all the resources we have found, but am frustrated at how hard we had to work to find them, especially since some were found entirely by happenstance. Without a few lucky accidents, we'd still be looking.
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